Highmark Health approved as Managed Care Organization for West Virginia Medicaid recipients

The West Virginia Department of Human Services (DoHS), Bureau for Medical Services (BMS) approved the Highmark Health Options West Virginia (HHO WV) application to become a Managed Care Organization (MCO) option for Medicaid eligible West Virginians. HHO WV Blue Cross and Blue Shield-branded health plans will be an option for West Virginia Medicaid beneficiaries beginning in June, for a July 1, 2024 coverage date.

“This partnership is a testament to our unwavering commitment to the well-being of West Virginians,” said Cindy Beane, DoHS Bureau for Medical Services Commissioner. “It signifies our continued commitment to ensuring comprehensive and accessible health services for our Medicaid members and fostering a healthier tomorrow for all.”

HHO WV’s parent company, Highmark Inc. (Highmark), has a more than 30-year history serving Medicaid enrollees. Highmark, one of the 10 largest health insurers in the United States, currently cares for more than 500,000 Medicaid beneficiaries across three states.

“We appreciate the trust the state has shown in us through this selection,” said Jason Landers, HHO WV president. “It’s an honor and privilege to serve all West Virginians, and a responsibility we don’t take lightly. We are excited to provide a Blue Cross Blue Shield insurance plan that will make the state proud.” 

The statewide contract between HHO WV and BMS will be in effect for four years. BMS contracts with three other MCOs for the provision of Medicaid medically necessary services: Aetna Better Health of West VirginiaThe Health Plan of West Virginia, and UniCare. Services carved out of managed care include point of sale pharmacy, long-term care, Home and Community-Based waivers, and non-emergency medical transportation services.

West Virginians interested in HHO WV can enroll beginning in June. First-time Medicaid beneficiaries can enroll through wvpath.wv.gov, calling 1-877-716-1212, or visiting their local DoHS office, formerly a part of the West Virginia Department of Health and Human Resources (DHHR). Current beneficiaries interested in switching to HHO WV should visit mountainhealthtrust.com/enroll or call 1-800-449-8466.

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